Order Form

Please fill up everything in full :D

Step 1: Highlight required text.
Step 2: Press Ctrl C.
Step 3: Go to your email, press Ctrl V.
Step 4: Fill up all the information.
Step 5: Send to zipia.madness@gmail.com.


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Spree Name: Zipia Spree 71
Name:
Email:
HP No.:
Full Address(w/ postal code):
Payment Mode: POSB iBanking or ATM transfer only
Bank Acc Type & No.: POSB Savings 000-00000-0
Type of Postage: Registered only

Your Orders:

Item #1
Full Name w/ Code(For all sprees): 1035-high waist short jean-57-D06548
URL(For all other sprees except Zipia Spree):
Colour:
Size:
Qty:
Price:
Alt if OOS:

Item #2
URL:
Full Name w/ Code:
Colour:
Size:
Qty:
Price:
Alt if OOS:

Total No. of Items:
Total Amount in US$:

Transaction Details
IB nick:
Amount: S$
Transaction Reference:
Date/time:

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